{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T09:43:24Z","timestamp":1786787004711,"version":"build-2736575974"},"reference-count":54,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2019,11,20]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>Vagus nerve stimulation (VNS) is a neuromodulatory therapeutic option for drug-resistant epilepsy. In randomised controlled trials, VNS implantation has resulted in over 50% reduction in seizure frequency in 26%\u201340% of patients within 1\u2009year. Long-term uncontrolled studies suggest better responses to VNS over time; however, the assessment of other potential predictive factors has led to contradictory results. Although initially designed for managing focal seizures, its use has been extended to other forms of drug-resistant epilepsy. In this review, we discuss the evidence supporting the use of VNS, its impact on seizure frequency and quality of life, and common adverse effects of this therapy. We also include practical guidance for the approach to and the management of patients with VNS in situ.<\/jats:p>","DOI":"10.1136\/practneurol-2019-002210","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T17:15:16Z","timestamp":1577812516000},"page":"189-198","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":74,"title":["Vagus nerve stimulation for drug-resistant epilepsy"],"prefix":"10.1136","volume":"20","author":[{"given":"Laura","family":"P\u00e9rez-Carbonell","sequence":"first","affiliation":[{"name":"Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Faulkner","sequence":"additional","affiliation":[{"name":"Neurology, Southmead Hospital, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Higgins","sequence":"additional","affiliation":[{"name":"Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michalis","family":"Koutroumanidis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Leschziner","sequence":"additional","affiliation":[{"name":"Sleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK"},{"name":"Department of Neurology, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,12,31]]},"reference":[{"key":"2025090409532065000_20.3.189.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1004418"},{"key":"2025090409532065000_20.3.189.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002033420503"},{"key":"2025090409532065000_20.3.189.3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1001\/jamaneurol.2017.3949","article-title":"Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs","volume":"75","author":"Chen","year":"2018","journal-title":"JAMA Neurol"},{"key":"2025090409532065000_20.3.189.4","doi-asserted-by":"crossref","unstructured":"Panebianco M , Rigby A , Weston J , et al . 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